Shanthi Mogali, M.D.
Individual provider Active NPI Addiction Psychiatry Physician · Canaan, CT
NPI 1144406802 · NPPES record last updated Dec 8, 2016
Key facts
- NPI
- 1144406802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction Psychiatry Physician 2084P0802X
- License
- 53341 (CT)
- Practice address
- 187 S Canaan Rd
Canaan, CT 06018-2544 - Phone
- (800) 362-5229
- NPI assigned
- Jan 11, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Addiction Medicine
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Northeast Medical Group Inc
Practice addresses (Care Compare)
25 Wells St
Westerly, RI 02891-2922
Phone (401) 596-6000
365 Montauk Ave
New London, CT 06320-4700
Phone (860) 444-3735
Hospital & facility affiliations
- Lawrence & Memorial Hospital
- Westerly Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 86.54
- Promoting interoperability
- 99.98
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CT, RI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191126002933 | CT | Practitioner - Psychiatry |
6406289792 | Reassigns benefits to 3 organizations |
| I20220601000143 | RI | Practitioner - Addiction Medicine |
6406289792 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53341 | CT | MD | Addiction Psychiatry Physician |
| 261192 | MA | MD | Addiction Psychiatry Physician |
| 251965 | NY | MD | Addiction Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Natchaug Hospital, Inc. | Current |
Accepting new patients | |
| Northeast Medical Group, Inc. | Current |
Accepting new patients | |
| Yale University | Current |
Accepting new patients | |
| Yale University | Current |
Accepting new patients |
Locations
189 Storrs Rd
Mansfield Ctr, CT 06250
Phone (860) 456-1311
800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140
365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364
95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388
99 Hawley Ln
Fl 3
Stratford, CT 06614
Phone (203) 502-4650
25 Wells St
Westerly, RI 02891
Phone (401) 348-3325
45 East Ave
Westerly, RI 02891
Phone (401) 596-6000
Interoperability endpoints
- smogali573355@direct.ynhh.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Psychiatry Physician | 2084P0802X | 251965 | NY | |
| Addiction Psychiatry Physician | 2084P0802X | 53341 | CT | Yes |
| Addiction Psychiatry Physician | 2084P0802X | 261192 | MA |
Addresses
Primary practice location
187 S Canaan Rd
Canaan, CT 06018-2544
Mailing address
187 S Canaan Rd
Canaan, CT 06018-2544
Other providers in Canaan, CT
- MC1 Healthcare
- MC2 - Healthcare
- Patricia McAllister
- McCall Foundation, Inc
- Emily Midwood
- Mountainside Treatment Center
- Chelsi Munning
- Meliha Muskic
- Natural Pediatric Medicine, LLC
- Anthony Joseph Nave Jr.
All providers in Canaan, CT · Addiction Psychiatry Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 8, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.